Melomag Issue 34 | 2019

melomag Free Heal th Guide

Know all about

MEASLES

Issue 34 | 2019

What to know about

STARTING SOLIDS

RECIPE:

HEARTY BEAN SOUP

Pass the Salt |12|

The latest health news and views |2|

First Aid: Treating Blisters|24|

Published in t he interest of your healt h by MELOMED

| UPFRONT |

melomag

GIVE-AWAY

Melomag is giving away a relaxing massage vouche r to one lucky reader!

See page 18 for details.

contents 2 Snippets: Health News & Views 4 Melonews 6 Infographic: Do you have the flu?

8 Your Health: Tuberculosis (TB) in the workplace 12 Health Strategy: Pass the salt 15 All About: Measles. Not just a little rash 18 Give-away! WIN a Massage Voucher!

19 Know It All: Starting solids 22 Melomed Renal Care: All about DIALYSIS 24 First Aid: Treating Blisters 28 Travelground: Think inside the box!

30 Recipe: Hearty Bean Soup & Honey Oat Bread 32 Housecall: Dr Sizwe Makhoba

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Health Bytes

Publisher: Health Bytes CC Contact: christa@health-bytes. co.za Tel: 021 913 0504 Proofing: Albert Buhr Printing: Kadimah

INDEMNITY: The information contained in Melomag is intended for general informational and educational purposes only, and not to replace professional medical advice. Persons requiring any medical advice or treatment should consult their relevant qualified healthcare professional. The publisher cannot accept any responsibility for any act, omission, loss, damage, or the consequences thereof caused by reliance by any person upon the information contained in the publication.

The information included in Melomag is subject to copyright and all rights are reserved. The information may not be sold, resold, transmitted or otherwise made available or disseminated in any manner via any media to third parties unless the prior written consent of the publisher has been obtained.

SNIPPETS

HEALTH NEWS & VIEWS

WASABI DOES MORE THAN MAKE SUSHI

that many human stomach cancer cells changed morphologically followed by cell death in a medium of wasabi extract. Besides the throat-and-nose Commonly known as “Japanese horseradish,” burning sensation, and clearing of the sinuses, wasabi is a member of the mustard family there are no known sideeffects attributed to wasabi and is noted for the consumption, although short-term burning some individuals may sensation it produces experience an allergic in the nasal cavity. But historically, wasabi served a reaction. purpose other than adding However, since “real” a spicy flavour to raw fish. wasabi is difficult to cultivate, much of the Wasabi has antimicrobial green paste on the market properties which may today is horseradish that have safeguarded is dyed green. As a result, Japanese sushi eaters the allergic reaction is often over the years. Specifically, due to either the dye or the “6-methylsulfinylhexyl horseradish. isothiocyanate” has been identified in wasabi as Although further research an anti-microbial agent needs to be conducted, effective against bacteria wasabi’s medicinal potential such as E. coli and seems quite promising.

Staphylococcus aureus.

Maybe in the future, instead of fluoride-enriched Wasabi’s antimicrobial effect may yet be directed toothpaste as a means of cavity control, we may against another scourge, be urged to eat a plateful namely, tooth decay. of sashimi with plenty of Other health benefits wasabi! may include wasabi’s anti-cancer properties.

Source: www.mcgill.ca Researchers have found

DIRTY SECRETS ABOUT HAND HYGIENE

Make sure to practise proper hand hygiene this season to prevent the spread of germs and the flu.

Wash your hands!

1. Germs can survive on hands for up to 3 hours.

2. A sneeze propels up to 100 000 bacteria into the air at 160kmh.

3. Damp hands spread 1000 times more germs than dry hands.

4. Nearly 80% of sicknesscausing germs spread via hands.

5. More germs exist on a phone or keyboard than a toilet seat.

6. Flu germs can spread an entire day before symptoms begin.

7. A single germ can multiply to more than eight million germs in one day.

Source: www.cdc.gov

HEALTH TIP:

SOCIAL MEDIA AND (BODY) IMAGE Social media might have a negative influence on how people may view their body.

If you find yourself spending too much time on social media every day, try to be more deliberate about your phone use.

• Limit your social media checks to a few certain times per day.

• When you’re at work, get up and walk around instead of looking at your phone.

• Unfollow or block people who make you feel bad about yourself. | 2 | MELOMAG

CANCER-SNIFFING DOGS? NO IT’S NOT SCI-FI. A new study has shown that dogs can use their highly evolved sense of smell to pick out blood samples from people with cancer with almost 97% accuracy.

Dogs have smell receptors 10 000 times more accurate than humans’, making them highly sensitive to odours we can’t perceive. A new study at BioScentDx has shown that dogs can use their highly evolved sense of smell to pick out blood samples from people with cancer.

“Although there is currently no cure for cancer, early detection offers the best hope of survival,” said Heather Junqueira, lead researcher.

“A highly sensitive test for detecting cancer could potentially save thousands of lives and change how the disease is treated.”

Researchers used a form of clicker training to teach four beagles to distinguish between normal blood serum and samples from patients with malignant lung cancer.

Although one beagle – aptly named Snuggles – was unmotivated to perform, the other three dogs correctly identified lung cancer samples 96.7% of the time and normal samples 97.5% of the time.

The results are very exciting, because it could lead to new cancer-detection tools that are inexpensive and accurate without being invasive.

Source: www.technologynetworks.com/biopharma/news

LEAD A BALANCED LIFESTYLE CANSA invites you to join its 365 Day Health Challenge and to eat and drink smartly. Research strongly indicates that making smart choices regarding what is taken in and exercising regularly can have a positive effect, not only on your well-being, but also on reducing your individual cancer risk.

Green = Go for it! (Lower cancer risk) – Aim to eat up to five to seven portions of non-starchy vegetables and fruits in season every day where possible; include wholegrains and minimally processed grains as a source of fibre (30g daily) and get active and exercise.

Orange = Take care! (Can influence cancer risk) Be aware of eating habits that could influence your risk of developing cancer. So avoid foods that are high in kilojoules, sugar and fat, which eaten very often could cause weight gain. Cut down on processed and fast-foods.

Red = Beware! (Increased cancer risk) Limiting red meat to less than three portions a week, eating less foods cured by using a lot of salt, and avoiding alcohol is advised.

Please visit the CANSA website (www.cansa.org.za) for detailed tips regarding smart, balanced nutrition.

| 3 | MELOMAG

| MELONEWS |

Melomed’s New Pharmacy Graduates

FROM LEFT TO RIGHT

Kim Cornelius, Aaliya Tayob; Shani Retief; Nishaat Jackson; Nafeesa Dhansay; Masood Abrahams; Mogamad Aarif Mohamed; Heinrich Williams and Ziyaad Abrahams

The Melomed Private Hospital Group and Stellenbosch University, more specifically the Faculty of Medicine and Health Sciences, have successfully established a partnership for the training of medical undergraduates. The collaboration between the respective parties started in 2017 and Melomed Gatesville Hospital is now officially an accredited facility to provide such excellent teaching and training.

Chairman of Melomed Mr Ebrahim Bhorat and Professor Rafique Moosa, the executive head at the department of medicine, signed the 2019 memorandum of agreement to ensure the ongoing support and collaboration. | 4 | MELOMAG

Melomed Gatesville celebrated 30 years of providing affordable and quality healthcare. The chairman and founder Mr E Bhorat and the management of the hospital treated staff to delectable treats as part of the celebrations. | 5 | MELOMAG

Influenza or “the flu”, is a contagious disease caused by seasonal influenza viruses that infect the nose, throat and lungs.

ARE YOU EXPERIENCING...

YES Fever; chills; cough; fatigue; headaches; sore throat; runny or stuffy nose; muscle or body aches

NO!

DID YOU GET A FLU SHOT?

Then you probably don’t have the flu

NO!

YES

YOU MAY HAVE THE FLU!

The flu shot protects against the most common flu strains, so you probably don’t have the flu, but there’s a chance you may.

Most people who get the flu get better without having to see their doctor. But if your flu symptoms get worse, if you have a high temperature for more than a few days, if you have any trouble breathing, or if you seem to get better but then feel worse again, call your doctor right away.

When you are sick, limit contact with others as much as possible. Remember to cover your nose and mouth when you cough or sneeze, and throw tissues in the trash after you use them. Stay home for at least 24 hours after your fever is gone, except to get medical care or for other necessities.

Take advantage of down time and give your body some much-needed rest. Curl up on the couch and spend some time reading, watching movies, or just cat-napping while your body battles the virus.

1. Stay home and avoid contact with others! You're sick – and very contagious!

2. Rest. Your immune system needs a lot of sleep to recover.

3. Drink lots of fluids. Water, fruit juices , soup.

4. Treat aches and fever with over-the-counter medication.

5. Take care of your cough so you can rest easier.

Getting a flu vaccine each year is the best way to prevent the flu.

Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are in the vaccine.

Vaccination is especially important for those at high risk of influenza complications: Pregnant women, People above 65 years of age, Children between 6 months and 5 years of age, People with chronic medical conditions and people who live with or care for those at high risk.

| YOUR HEALTH | Dr J C Mogambery FCP(SA) Cert IDPhys(SA) Specialist Physician at Melomed Richards Bay Tel: 035 772 2002 Emergency: 061 422 1932

Tuberculosis (TB) is a disease caused by bacteria (Mycobacteria tuberculosis) that are spread through the air when infected people cough or sneeze. TB is highly prevalent in South Africa, therefore it is not uncommon for employers and coworkers to find themselves in contact with infected individuals at the workplace.

WHAT ARE THE SIGNS AND SYMPTOMS OF TB? Most people exposed to TB never develop symptoms, since the bacteria can live in an inactive form in the body.

It is important to screen employees and ensure an early diagnosis of the condition in order to prevent transmission to others and to allow the infected person to be | 8 | MELOMAG

treated timeously.

Some of the symptoms and signs include:

WHAT SHOULD YOU DO

• Persistent cough associated with sputum production with or without blood • Chest pain • Fever and night sweats • Loss of weight and poor appetite • Lumps in the neck or in the armpits (lymph nodes).

WORKER HAS TB?

IF YOU SUSPECT THAT AN EMPLOYEE OR CO-

The individual should be referred to the occupational health clinic or local primary healthcare clinic where he/she can be tested.

Sputum should be expectorated into a specimen bottle and sent

DID YOU KNOW? TB is the #1 killer.

Worldwide, TB is the leading cause of death from a single infectious agent (above HIV/Aids). to a pathology laboratory for a microscopic examination and GeneXpert Test. A chest x-ray may be indicated. If the diagnosis is difficult to make a doctor may need to be consulted.

HOW LONG DOES THE TREATMENT COURSE LAST? A course of treatment for uncomplicated TB usually lasts for 6 months.

It includes two months of intensive phase where 4 drugs are administered in a fixed dose combination tablet.

The last 4 months, called the continuation phase, includes 2 drugs in a fixed-dose combination tablet. The dosages are weight-dependent. The individual will need to test his/her sputum after two months to ensure that the treatment has been effective.

Treatment for multidrugresistant TB (MDR-TB) is especially arduous, taking up to two years and causing many side effects. When patients show resistance to MDR-TB drugs, they are considered to have extensively drugresistant TB (XDR-TB) and have even fewer treatment options.

TB kills one person every 18 seconds, yet the disease can be prevented, treated and cured.

AM I AT RISK OF ACQUIRING TB FROM MY EMPLOYEE OR CO-WORKER? TB is transmitted in airborne particles so if you have worked in close proximity or in a poorly ventilated room with an individual who has untreated tuberculosis you are at risk. If symptoms develop you should be tested for TB. You have an increased risk of acquiring TB if your immune system is compromised. Illnesses that compromise the immune system include diabetes mellitus, HIV infection (especially those who are not treated), silicosis, and other chronic conditions like renal disease or heart failure.

In 2017, 10 million people became ill with TB and 1.6 million people died from the disease. the sensitivity of rifampicin, which is one of the main drugs used to treat TB. If the TB bacilli are sensitive to rifampicin it usually means that the TB is drug-sensitive.

At times the diagnosis of TB is made without the GeneXpert test. In these cases, sputum or infected tissue should be sent to a laboratory for TB culture.

Once TB is cultured, the sensitivity of most TB drugs can be determined.

Another way to determine if TB is drug sensitive is clinical monitoring. The individual should be feeling much better after two months of TB treatment if the TB is drug-sensitive.

HOW MUCH LEAVE DOES AN EMPLOYEE NEED

HOW LONG DOES IT TAKE

ONCE TREATMENT HAS

FOR AN INDIVIDUAL

BEEN STARTED?

WITH TB TO BECOME NON-INFECTIOUS? If the medication is taken appropriately and the TB is sensitive to the treatment, the individual should become non-infectious after 2 weeks.

HOW DO YOU KNOW IF TB IS DRUG SENSITIVE?

The individual should be granted sick leave for the first two weeks to ensure that the infection is not transmitted to his or her co-workers.

Caution the individual to avoid contact with young children and people who may be at risk of getting TB during this infectious period.

The GeneXpert test is able to provide information on

| 9 | MELOMAG

| YOUR HEALTH | WHAT ARE SOME OF THE COMMON SIDE EFFECTS OF TB TREATMENT? Once treatment has been commenced, the individual has committed to taking four different drugs for two months.

Each drug has its own set of side effects. Some common side effects to look out for are as follows: • Nausea and vomiting • Orange discolouration of urine and tears • Painful feet (pyridoxine will always be added to the TB treatment to avoid this side effect) • Problems with vision • Jaundice (yellow eyes) If the individual develops severe vomiting, jaundice,

More information can be found on the following websites: South African Labour Guide

https://www.labourguide.co.za/health-andsafety/1374-tb-what-employers-should-know Patient information pamphlets https://www.cdc.gov/tb/publications/ pamphlets/default.htm National TB Guidelines http://www.tbonline.info/media/ uploads/documents/ntcp_adult_tbguidelines-27.5.2014.pdf World Health Organization’s Global Health Report 2018

| 10 | MELOMAG

problems with vision, confusion or rashes after starting TB treatment, he or she should see a physician urgently.

weeks if the CD4 count is less than 50 cells/mm3

ARE TB AND HIV LINKED?

PROGRAMME?

Yes. According to the World Health Organization, people living with HIV have a 16–27 times greater risk of developing tuberculosis, the risk being higher in individuals with a CD4 count less than 200 cells/mm3.

In order to stop the disease from spreading it is important that we all take responsibility for the prevention and control of tuberculosis. Some steps include implementing measures to minimise transmission risk, TB awareness and education, active promotion of a good screening programme for TB and HIV and implementation of a directly observed treatment short-course (DOTS) programme for those on treatment in the work place.

It is imperative that an HIV test is done so that in the event of a positive result, antiretroviral therapy (ART) can be planned for and initiated once the individual is stable on TB treatment.

Studies have shown that ART should be commenced within 2–8 weeks of starting TB treatment, and within 2

HOW CAN THE WORKPLACE IMPLEMENT A TB CONTROL

ME LO

ARE YOU EXPECTING? FREE ANTENATAL CLASSES & BIRTH REGISTRATION. Our Melobabes Maternity Programme supports expectant mothers with their exciting journey ahead.

Sign up today! Ask your gynaecologist for a Melobabe registration form.

For more information regarding the support group in your area, contact info@melomed.co.za.

www.melomed.co.za

PROVIDING AFFORDABLE QUALITY HEALTHCARE.

| HEALTH STRATEGY |

A just-released survey shows how little South Africans still know about the salt content in everyday food items. The findings were released during the World Salt Awareness Week in an effort to create more public awareness of the health dangers associated with consuming too much salt.

While most food items don’t exceed the daily limit of 5g of salt per day, it is the combined amount of salt from all the foods we eat in a day that often amounts to eight times the recommended daily allowance, putting South Africans in the red zone for heart disease.

To test SA’s salt-smarts, a prevention-minded pharma company conducted an online poll among men and women

| 12 | MELOMAG

across the country in the weeks leading up to World Salt Awareness Week (4 – 10 March). Here are some of the findings: A quarter of South Africans conceded to being salt addicts, with 31% adding salt to their food “all the time” and 37% “some of the time”.

Most also still don’t have a handle on how much salt is used in popular foods such as cereal, yoghurt and chips.

Nicole Jennings, spokesperson for Pharma Dynamics – SA’s leading provider of cardiovascular medication – says hypertension rates in SA are alarmingly high and continue to climb.

“A leading cause of the condition is too much salt consumption, which heightens the risk of heart disease and stroke. There are various ways in which excessive salt consumption can impact

our blood pressure and put great strain on our hearts, arteries and kidneys.”

“We live in a fast-paced society, where take-outs and ready-made meals reign supreme, but these are often laden with salt.”

The survey, which polled 245 men and women, found that while more than 90% understood the link between high blood pressure and excessive salt consumption, very few actually knew just how much salt is contained in food that is consumed on a daily basis.

More than 64% of respondents didn’t know that there is about 1.5g of salt in a slice of pizza; 45% were off the mark with how much salt was in a small tub of plain yoghurt; which is in the region of 3.5g; 60% guessed wrong about the quantity of salt in a bowl of cornflakes with milk and 68% didn’t know how much salt was in a handful of peanuts.

“While efforts have been made since 2016 by government to reduce salt levels in food, with a second set of even lower levels of salt being introduced this year, the public should be made more aware of foods that are high in salt as many don’t pay attention to food labels,” says Jennings. >

IN AN EFFORT TO MAKE THE PUBLIC MORE SALT SAVVY, PHARMA DYNAMICS HAS COMPILED A LIST OF FOODS THAT ARE TYPICALLY HIGH IN SALT: VERY HIGH IN SALT Cheese: flavoured cream cheese and cottage cheese Tinned foods: especially those preserved in brine Stock powders or cubes Soup powders or tinned soups Marinades or marinade powders Olives and pickles Any processed meat: polony, salami, turkey, sausages, Viennas, etc.

Takeaway fast-foods: like burgers, fish and chips, pizzas and Chinese takeaway Seasoning salts, like barbeque or chicken spice Salty spreads: including margarine, butter, cheese spreads and meat spreads Cured meat and fish: bokkoms, biltong, anchovies, corned beef Instant noodles with flavouring Worcestershire sauce and soy sauce Crisps, salted biscuits and crackers and ready-made popcorn

MODERATELY HIGH IN SALT Pre-prepared meals or convenience foods Shop-bought biscuits, cakes and treats Salad dressings and mayonnaise Salted nuts

SURPRISINGLY CONTAIN SALT Ready-made desserts Some yoghurts Bread Breakfast cereals

| 13 | MELOMAG

According to the Heart and Stroke Foundation, South Africa has the highest incidence of high blood pressure among people aged 50+ compared to any other country in the world, with almost 8 in 10 people in this age group being diagnosed with high blood pressure.

However, younger people are also at risk with an estimated 1 in 3 South Africans older than 15 having high blood pressure. Jennings believes that the country’s high hypertension rates should be tackled early in childhood already.

“In many cases, adult hypertension has its roots in childhood, yet worryingly

Source: Meropa Communications on behalf of Pharma Dynamics. | 14 | MELOMAG

very little is being done to make children aware that salt can lead to heart disease.

could be decreased by 7 400 and would result in 4 300 fewer non-fatal strokes per year.

If healthy habits, which includes a reduction in salt intake, can be formed in early years, it could significantly decrease the burden of heart disease in our country.”

“It’s essential that South Africans take steps to make sure they know how much salt is in all the food they eat and try to cut back as much as they can. When checking food labels, look out for other terms often used to describe salt, such as monosodium glutamate, nitrates and nitrites, so you’re aware of how much salt you’re putting into your body. Also try to avoid salting food that has already been salted,” encourages Jennings.

Based on recent research published in the SA Medical Journal (September 2018), 1 in 5 children at the age of 5 is hypertensive and 60% of children with elevated blood pressure maintain that status into adulthood.

By decreasing salt consumption by even just 0.85g per day, deaths related to heart disease

For nutritional advice and recipes that are low in salt, visit www. cookingfromtheheart.co.za

| ALL ABOUT |

Worldwide, measles has become rare, thanks to widespread vaccination. In the year 2000, the Centre for Disease Control and Prevention declared measles “eliminated�.

However, given the increasing number of

parents opting their children out of getting vaccinations, measles has crept back.

An estimate of one out of four people with measles will need hospitalisation and every year several people die as

a consequence of measles infection.

Measles is not a harmless childhood disease. It spreads incredibly easily. In fact, 9 out of 10 people who are not vaccinated, will get it if they are near an infected person. > | 15 | MELOMAG

What Is Measles?

Measles (also called rubeola) is a very contagious respiratory infection. It causes a totalbody skin rash and flu-like symptoms.

Measles is caused by a virus, there is thus no specific medical treatment for it. The virus has to run its course. A patient who is sick should drink plenty of liquids, get lots of rest, and stay home to prevent spreading the infection.

What Are the Signs and Symptoms of Measles?

A case of measles usually includes the following symptoms of which the first symptoms usually appear 10 to 12 days after infection: a runny nose, hacking dry cough and a fairly high fever. The eyes also become red and sensitive to light.

Unfortunately, because of those early symptoms, people might at first think they have a common cold.

Sources: https://www.cdc.gov/measles/index.html https://kidshealth.org

| 16 | MELOMAG

The danger is that all that time the infected person is contagious with measles and could unknowingly be spreading their infection to others.

As the illness progresses, on the third to seventh day, the temperature may reach 39 to 41 °C, and a red rash appears that lasts four to seven days.

Once the rash appears, it starts on the face and spreads to the trunk (back and chest/stomach) and outward to the arms and legs.

Usually the rash does not spread to palms of the hands or soles of the feet.

The rash itself is macular (flat) and erythematous (red).

Sometimes the rash will gather to form larger “splotches”. Patients can also have a rash in their mouth, called Koplik spots, which are whitish in appearance and usually line the insides of the patient’s cheeks.

How Do People Get Measles?

Measles spreads when people breathe in or have direct contact with virusinfected fluid. It can pass through droplets sprayed into the air when someone with measles sneezes or coughs. Someone exposed to the virus usually shows symptoms 7–14 days later.

People with measles can spread the disease from 4 days before the rash starts until about 4 days after.

They’re most contagious while they have a fever, runny nose, and cough.

Those with weakened immune systems can spread the measles virus until they recover.

How Is Measles Treated?

There is no specific medical treatment for measles. To help manage symptoms: • Drink plenty of fluids • Encourage extra rest • Treat the fever. Never give aspirin to a child who has a viral illness, as such use is linked to Reye’s syndrome.

MEASLES FACTS: • • •

1 out of 4 people who get measles will need hospitalisation.

1 person with measles can infect an average of 12–18 unprotected people.

Up to 1 in 1000 measles patients die as a result of the disease.

Approximately 30% of reported cases have one or more complications, especially among children under 5 years of age and adults over 20. Measles can be more severe in people with weakened immune systems.

Complications from measles infection • 7 to 9 out of 100 children develop ear infection, which can result in hearing loss.

• 8 out of 100 patients report diarrhoea.

• 1 to 6 out of every 100 patients suffer from pneumonia. This is the most common cause of death from measles.

• 1 in every 1 000 patients develop acute encephalitis (swelling of the brain). This can lead to convulsions and leave a child deaf or with mental disability.

• Eye disorders, such as destruction of the cornea (outer layer of eyeball) may lead to blindness.

This condition affects, in particular, malnourished children and is linked to vitamin A deficiency.

• A rare but fatal brain complication known as subacute sclerosing panencephalitis (SSPE), can occur several years after measles.

How Long Does Measles Last?

A measles infection can last for several weeks. Patients with measles should be kept away from others for 4 days after their rash appears. For those with a weakened immune system, this should continue until they make a full recovery and all symptoms are gone.

The virus can survive in air for about 2 hours, so people should minimise contact with the infected person and stay out of the room where they’re resting. This is particularly important for patients who are young, old, pregnant, or have a weakened immune system. As mentioned earlier, measles spreads VERY easily.

Can Measles Be Prevented?

age and the strength of her or his immune system.

Vaccination is the only measure that prevents infection. There is no scientific evidence that natural remedies, diets or lifestyle changes reduce the risk of measles.

The two-dose measlesmumps-rubella vaccine (MMR) is about 97% effective at preventing infection.

Therefore, if an individual has been vaccinated appropriately, it is unlikely that they could contract measles, but not impossible. For most kids, measles protection is part of the MMR vaccine given when they’re 12 to 15 months old and again when they’re 4 to 6 years old.

Yes, it is a preventable disease. Measles vaccination protects you and your family.

By vaccinating against measles, you contribute to a healthy community.

It’s important for all kids who can get the vaccine to get it on schedule. At-risk people (such as those with weakened immune systems) can’t get the vaccine and depend on “herd immunity”.

An unvaccinated person who is exposed to measles has a 90% probability of becoming sick. This is regardless of

This is when a lot of people are immunised against a disease, which prevents it from spreading and helps prevent outbreaks. >

| 17 | MELOMAG

When Should I Call the Doctor?

Call the doctor right away if you think that someone has measles.

Also call if your child or an adult was around someone who has measles, especially if the patient: • is an infant • is taking medicines that suppress the immune system • has tuberculosis, cancer, or a disease that affects the immune system Why Is Vaccination Important?

Widespread immunisation has made measles rare. But outbreaks do still happen.

An outbreak is when a disease happens in greater numbers than one would

expect in a certain area.

Measles outbreaks have been increasing worldwide, mostly due to people not being vaccinated.

At highest risk during a measles outbreak are: • infants who aren’t old enough to get the vaccine • pregnant women • people with poor nutrition or weakened immune systems Now to calm some alarm: Just because someone is having a viral rash or symptoms of a cold, that does not mean they have a measles infection. That’s unlikely to be the case.

However, as with all uncommon things in medicine, doctors need to

Melomed is giving away a relaxing massage to one lucky reader!

To stand a chance to qualify, email your name, contact number and answer to the following question to: melomag@melomed.co.za with Melomag34 in the subject line. Competition closes 28 June 2019.

What’s the best way to protect yourself against the flu? (see page 7) Prize sponsored by Melomed. Give-away term and conditions: The winner will be the first correct entry drawn after the closing date. In the event of the judges not being able to get a hold of the winner on details supplied, an alternative winner will be selected. The judges’ decision is final and no correspondence will be entered into.

The winner must be prpared to be photographed for plublicity purposes. The prize is not transferable and may not be converted into cash. Prize may differ from picture. Image is for visual purposes only.

| 18 | MELOMAG

be vigilant and diagnose the condition, especially since measles cases have cropped up again.

Let this be the point that puts measles on your radar: Since patients can be contagious up to five days before the rash starts and remain contagious four days after the rash appears, and since measles is highly contagious and has the potential to spread rapidly before anyone even recognises there may be an outbreak, it’s clear why vaccination against this preventable disease is so important.

This is especially critical to protect the health of patients who cannot be vaccinated.

| KNOW IT ALL | Annette Bing Certified Lactation Consultant and Midwife

WHY, WHEN, WHAT and HOW? STARTING SOLIDS CAN SEEM OVERWHELMING FOR A NEW PARENT, ESPECIALLY WHEN YOU’RE OVERLOADED WITH CONFLICTING INFORMATION ABOUT WHAT, WHEN, AND HOW TO DO IT. WHY IS COMPLEMENTARY FEEDING SO IMPORTANT?

skills that she’ll need later for language development.

Complementary feeding means giving other foods in addition to breast milk.

Complementary feeding is needed to provide energy and essential nutrients required for continued growth and development.

Consequences of poor nutrition in the complementary feeding phase are:

The nutrients in recommended complementary foods complement those in breast milk, hence the name.

Introducing solids is also important for helping your baby learn to eat, giving her experience of new tastes and textures from a range of foods, developing her teeth and jaws, and building other

• Chronic under-nutrition (especially protein) which leads to • Growth stunting • Increased later risk of cardiovascular disease • Cognitive and behavioural impairments • Strong predictor of achieved schooling and adult income & assets • Early over-nutrition leading to excessive weight gain is a strong predictor of later obesity and risk of noncommunicable disease (NCD).

What are the recommendations for complementary feeding?

It is recommended that solid food or other liquids be introduced around 6 months of age, as breastmilk (and/ or formula) can provide 100% of baby’s nutrition up to that point.

The WHO (World Health Organization) estimates that solid foods provide about 1/5 of a baby’s energy needs from 6 to 8 months and just under half of baby’s energy needs from 9 to 12 months.

Breastmilk and/or formula will continue to provide the bulk of your baby’s nutritional needs until one year.

| 19 | MELOMAG

WHEN?

Is he big enough?

Timing is important. You don’t want to start too early or too late. There is a window of opportunity around 6 months that seems to be the best time to start solids.

To know when exactly to start between these ages, it’s important to pay attention to your baby’s cues.

Can he swallow safely?

A baby’s ability to manage and safely swallow solid foods is not developed before about 6 months.

This is partly due to the fact that their gag reflex hasn’t fully developed, putting them at an increased risk of choking.

Here are some signs of readiness to look for: Can he sit up by himself and hold his head up straight? Your baby should be able to sit in a high chair, feeding seat, or infant seat with good head control and be able to hold himself up.

Does he show signs of interest in what you’re eating? Babies may be ready if they watch you eating, reach for your food, and seem eager to eat. They can open their mouths when food comes their way.

Is he able to pick up small objects?

When babies show signs of good fine motor co-ordination, they can refine their fine pincer grip and grab small bits of food, like a pea and direct this to their mouth.

Can he manoeuvre food from a spoon to the back of his throat?

If you offer a spoonful, and he pushes it out of his mouth and it dribbles onto his chin (the tongue thrust reflex), he may not be ready yet. You could try diluting it the first few times, then gradually thicken the texture, or you may also want to wait a week or two and try again. | 20 | MELOMAG

WHAT? WHAT? By 6 months, most babies are ready for a variety of food textures, ranging from thin purees to soft finger foods. It’s really up to the parent and their level of comfort. Some babies prefer to be spoon-fed purees at the start, while some prefer to dig into soft finger foods right at the get-go.

CHOICE OF COMPLEMENTARY FOODS • From 6 months, give meat, chicken, fish or egg every day, or as often as possible.

• Give a variety of vegetables and fruits, but especially dark-green leafy vegetables and orange-coloured fruits and vegetables every day.

• Rather give oats porridge or maize meal porridge than sweetened infant cereals.

You can experiment with various textures (lumpy, and tender-cooked and finely minced, pureed, mashed or ground) to see what your baby prefers best and even feed her a variety of textures daily.

By 9 months, your baby should be eating a variety of foods and textures and ideally participating in family meals!

Family foods may need to be modified in texture for your baby (they need to be soft enough) and free of added seasonings such as salt.

TEXTURES AND CONSISTENCIES: • Purees are safe at 4 to 6 months and mashed foods are safe at 6 months • Lumpy foods: better acceptance if introduced before 8 to 10 months • Finger foods: as soon as able to – typically by 8 to 9 months • Family foods by 12 months Safe finger foods include: pieces of soft-cooked vegetables and fruits; soft, ripe fruit such as banana; finely minced, ground or mashed cooked meat, deboned fish, and chicken; grated cheese; and wholegrain toast strips with a thin layer of butter or nut butter.

FLAVOUR PROFILES: • Inborn preference: sweet and salty • Substantially modified by early food experiences • Feed them what you want them to grow up eating!

WHAT TO AVOID: • Do not add sugar and salt to their diet • Sugar-sweetened beverages, including fruit juice • Drinks with low nutrient value e.g. tea, coffee • Foods that may cause choking • Avoid junk food / take-away food with low nutrient value • Cows’ milk only after 12 months

Note: infants eating a vegan diet may require supplementation or the use of fortified foods.

WHAT ABOUT INTRODUCING WHAT ABOUT INTRODUCING COMMON FOOD COMMON FOOD ALLERGENS? ALLERGENS? There is a lot of evidence that delaying the introduction of common allergens such as eggs, nut butters and fish, isn’t necessary and that it is safe to introduce them between 4-6 months under supervision.

In fact, early exposure to common allergens may even prevent allergies from developing! If there is a strong family history of allergies to certain foods, then

discuss the earlier and safe introduction of these foods with your paediatrician.

through a growth spurt • the types of foods they are eating

HOW SHOULD I FEED MY BABY? From 6 to 8 months, parents should gradually work towards offering solid foods 2 to 3 times a day (at mealtimes), and 1 to 2 snacks per day, depending on the baby’s appetite.

RESPONSIVE FEEDING PRACTICES:

Your baby’s appetite will vary from day to day depending on several factors such as: • how they are feeling • whether there are distractions present • the time of day • their breastmilk/formula intake • whether or not they are going

• Feed in response to your baby’s hunger and satiety cues • Encourage them to eat but do not coerce/force • Encourage self-feeding, but assist as necessary • Use age-appropriate utensils • Comfortable environment • Caregivers should be aware of and responsive to babies’ emotional state. Try and feed them before they are overtired or over-stimulated.

DO NOT use food as a reward or for comfort!

| 21 | MELOMAG

| ADVERTORIAL |

st Dispelling The Mo bout Common Myths A

PEOPLE WITH END-STAGE RENAL DISEASE (ESRD) MAY REQUIRE DIALYSIS, TREATMENTS THAT REPLACE KIDNEY FUNCTION BY REMOVING WASTES AND EXCESS FLUID FROM THE BODY. ALTHOUGH THE LIFE-SAVING NATURE OF DIALYSIS IS UNDISPUTED, SEVERAL MYTHS MAY CONTRIBUTE TO COMMON MISCONCEPTIONS ABOUT THE BURDEN OF BEING ON DIALYSIS. Myth #1: Dialysis isn’t for someone who fears needles.

TRUTH: Fear of needles and the pain associated with needle sticks is common for patients. To ease your fear, medications are available to numb the skin where your vascular access is before inserting the needle. Lidocaine, a local anaesthetic, may be an option used by your centre. | 22 | MELOMAG

Another way for patients to ease their fear of needles is self-cannulation, which allows you to insert your own needles into your access. Your dialysis care team can teach you how to self-cannulate.

Gaining control over the procedure may also make you more comfortable with it. Finally, peritoneal dialysis is a form of home dialysis that does not use needles.

Myth #2: Dialysis can be done only at the centre.

TRUTH: In-centre hemodialysis is just one of several dialysis treatment options, and it too offers a variety of choices, such as in-centre self-care and in-centre nocturnal dialysis.

However, an increasing number of patients are choosing to dialyse at home.

Peritoneal dialysis (PD) is the most common type of home dialysis. It works by using the peritoneal membrane to filter the waste and fluid from your bloodstream.

The peritoneal membrane is a thin membrane that lines the abdomen. No needles are involved as the dialysis solution is instilled into the abdomen through a permanent catheter.

Home hemodialysis (HHD) uses a hemodialysis machine to clean the blood the same way as it’s done in a centre but from the comfort of a patient’s home.

Your dialysis team (doctor and unit staff) can help determine which

treatment option may best match your lifestyle. Take the results to your doctor to discuss further when choosing your dialysis treatment.

Myth #3: People on dialysis can no longer travel.

TRUTH: You can still soak up the sun, camp, visit family or travel for work with some planning and dialogue between you, your doctor, nurse and social worker.

Patients on hemodialysis can arrange treatments at a centre at their planned vacation destination.

Patients on PD can have supplies directly delivered

to wherever they are going.

Ask your unit administrator or unit leader for a list of our national footprint of dialysis units. Alternatively, visit www.globaldialysis. com for a list of accredited dialysis centres across the globe.

Myth #4: There are too many things to learn about dialysis.

TRUTH: While there are many things to learn, whatever your treatment choice, there is an entire kidney healthcare team, including nephrologists, nurses, dietitians, social workers, care technicians and others, to support you throughout the dialysis process.

MELOMED RENAL CARE (MRC) MELOMED GATESVILLE: +27 21 637 1702 | C/O MELOMED GATESVILLE HOSPITAL MELOMED MITCHELLS PLAIN: +27 21 391 0816 | C/O MELOMED MITCHELLS PLAIN HOSPITAL MELOMED TOKAI: +27 21 712 5860 | C/O MELOMED TOKAI HOSPITAL | 23 | MELOMAG

| FIRST AID|

YOUR GUIDE TO TREATING BLISTERS TIPS TO PREVENT AND GET RID OF PAINFUL BLISTERS FAST!

Blisters on feet develop from rubbing and pressure, often forming while wearing uncomfortable shoes. Prevent and treat blisters with these tips and keep on walking!

HOW TO PREVENT BLISTERS

From walking to hiking to dancing all night, physical activity can trigger blisters.

So, how can you prevent them? And, once you get them, how should you treat them?

FOLLOW THESE RECOMMENDATIONS TO HELP YOU PREVENT BLISTERS:

Blisters are caused by friction. The soles of the feet and palms of the hands are prime sites for blisters to form.

When your skin rubs against another surface, the top layers of skin tear and create a space for fluid to accumulate. This liquid is supposed to cushion the wound and protect it from further pressure.

First, you’re likely to rub footwear or hand-held equipment (rackets, bats, etc) against these areas.

And secondly, hands and feet tend to sweat more – this warm, moist area is ripe for blister formation. | 24 | MELOMAG

Start by reducing the amount of sweat and friction on your skin. Humidity and leather are not a good mix.

• Wear comfortable shoes that fit correctly. Buy shoes later in the day as your feet will expand during the day. Break in new shoes by wearing them for a couple hours the first day, and then gradually increasing their use dayto-day.

• Wear socks: They can help reduce friction and moisture, especially socks made of a material that pulls moisture away from the skin.

• Double layering your socks can also help reduce friction. If you are working out or running, wear special socks that are enforced on toes or heels and don’t have seams.

• Use a drying agent: Drying agents, like foot powder, baby powder or cornstarch, reduce moisture and help keep your feet dry.

• Lubricate your feet, or other areas that are prone to blisters and chafing, with Vaseline. You may want to reapply it. You can find lubricant sticks at running stores and pharmacies.

HOW TO TREAT BLISTERS If you develop a blister, prompt treatment of your blister will help you get back to your activity sooner. Focus on reducing the pain and preventing the blister from getting larger by reducing the friction on the area.

The best treatment for blisters... is to leave them intact. In a protected environment the blister will heal off best and all by itself.

• Don’t puncture the blister.

• Carefully clean the blister with water and pat it dry.

• Then cover it with an adhesive bandage.

Sources www.ahchealthenews.com www.elastoplast.com www.webmd.co.za

If the blister comes open accidentally, don‘t pull off the outer skin layer. Leave it alone to heal, and cover it with a blister plaster. As long as it is covered, the wound is protected from infection.

It will protect the affected area from further pressure, friction and other harmful external influences.

A blister should not be opened because the blister roof protects against additional infection.

To drain a blister that is large, painful, or in an awkward spot it might be best to drain it:

With a blister, breaking its protective layer of skin allows bacteria to enter the wound, which is medically considered an open wound.

Nevertheless, if this does happen, you should disinfect the punctured blister (for example with an antiseptic spray) and cover it with a blister plaster.

• Wipe a needle and the blister with alcohol.

• Make a small hole at the edge of the blister. Gently press out the fluid.

• Wash the blister again and pat dry.

• Leave the loose skin in place.

• Apply antibiotic ointment.

• Cover the area loosely with a sterile bandage or gauze.

WHEN TO DRAIN A BLISTER

Always see your doctor if the wound is deep, bleeding or shows signs of infection like reddening, swelling or warmth.

Also if you have blisters that were not caused by friction and you have other symptoms.

Also make sure to seek medical help if you are not able to clean the wound properly.

In case you have diabetes a proper wound care is of special importance. Always discuss any concerns you may have with your doctor and/or podiatrist, even for the care of minor wounds and skin cracks – especially on your feet.

| 25 | MELOMAG

CARDIAC CENTRES OF EXCELLENCE ADVANCED STATE OF THE ART CARDIAC FACILITIES AT YOUR DOORSTEP. Melomed cardiac centres are geared to serve and provide 24-hour treatment to patients for all heart related illnesses. This includes a number of cardiac diagnostic and interventional procedures, within the Catheterization Laboratory (Cath lab) supported by established lnterventional Cardiologists.

Melomed Cardiac Centres of excellence offers: Electrophysiology (EPS), Diagnostic Angiograms / Diagnostic Coronary Angiogram, Coronary Artery Stenting, Rotablation for Coronary Artery Stenosis, Optis Integrated Optical Coherence Tomography (OCT) and Fractional Flow Reserve (FFR) system with Angiographic Co-Registration just to mention a few. *Interventional cardiologists are super specialists who can diagnose and treat a patient in the Cath Lab.

GATEVILLE Dr S Thakersee 021 638 3017

Dr MC Hendrickse 021 637 8218/9

TOKAI & BELLVILLE

BELLVILLE

Dr P Ntuli 021 764 7158

Dr V Freeman 021 949 9332

info@melomed.co.za

www.melomed.co.za

PROVIDING AFFORDABLE QUALITY HEALTHCARE.

| TRAVELGROUND |

FOR YOUR NEXT GETAWAY! We tend to go big or... stay home when looking for holiday accommodation. But what about thinking inside the box for a change when deciding on your next getaway? Creating striking accommodation from refurbished shipping containers or building smaller, box-like stays out of eclectic materials is becoming quite the trend. These types of stays have less of a construction footprint on the environment - more often than not they make use of old materials that might have otherwise ended up in landfills and they are a testament to what human ingenuity and a creative sense of style can achieve.

So don’t sit at home and feel boxed in next weekend. Have a look at these fabulous and fully kitted box-like stays for your next getaway!

THE AMBERLEY ANNEX Muizenberg FROM R550 PER NIGHT FOR TWO PEOPLE This quaint open-plan annex is a lovely addition to a 120-yearold house which used to be a war office. Nestled at the foot of the Muizenberg Mountain, it is just a few minutes from the renowned Surfer’s Corner and 70m from Muizenberg Station.

Though small, the unit has space for 2 on a double bed and comprises a bathroom with a shower, a kitchenette and a wooden deck. Free unlimited WiFi is available.

| 27 | MELOMAG

VILLA VILLEKULA ECO LODGE Plettenberg Bay FROM R1250 PER NIGHT FOR 2 PEOPLE This unique guesthouse is remotely located in The Crags, a short drive from Plett, making it the ideal place for those wanting to explore the wonders of the Garden Route. The 3.2-hectare property sports a dam and a small forest that guests can get lost in. Accommodation is offered in four individually decorated guest rooms, each with its own deck.

An à la carte breakfast at the restaurant next door is included in the rate.

THE SQUARE ELEPHANT Hermanus FROM R1896 PER NIGHT FOR 4 GUESTS This luxurious shipping container nestles in a nature reserve near Hermanus and is completely independent of Eskom electricity! Relax in the wood-fired hot tub with a panoramic view of the environment. The unit sleeps 4 guests in 2 bedrooms and comprises a kitchen, dining area, lounge and braai. Free WiFi is provided and pure drinking water flows from a natural water source in the area. A high-clearance vehicle is recommended for the 2,5km gravel road leading to this secluded stay.

UPENDO OFF-THE-GRID COTTAGE Suurbraak FROM R850 PER NIGHT FOR 3 PEOPLE This lovely self-catering cottage sleeps 2 adults and 1 child and is within walking distance of the river, waterfalls and pools in the mountains surrounding Suurbraak, a small town near Swellendam and Barrydale. The unit is powered by solar panels and the kitchen is equipped with gas cooking facilities. There is also an open-air bathroom with a spacious bath and a tree shower!

DRAYTON GUEST FARM Boland FROM R600 PER NIGHT FOR 2 PEOPLE Situated on one of the oldest farms in the Overberg, Drayton Guest Farm is just 8km from Caledon on the N2 and is well worth a weekend’s trip. As alternative construction methods are the owner’s passion, she had 2 shipping containers, Pietse-Kinders Unit 1 and 2, refurbished as 4 modern rooms which share a communal kitchen and bathroom. This stay is ideal for adventurous guests who enjoy being close to nature.

THE RIVERSTONE HOUSE Wolseley FROM R1500 PER NIGHT FOR 2 GUESTS Treat yourself and 9 friends to a breathtaking self-catering stay in a stylishly revamped shipping container on the dam wall of a farm in Wolseley, just 15 minutes from Tulbagh. With 4 bedrooms, 2 bathrooms, an open-plan entertainment area and kitchen, and verandas boasting a view of the Breerivier, the whole gang is sure to unwind and recharge. Free WiFi is available and your furry friend is also welcome if arranged prior to arrival.

| 28 | MELOMAG

Lower your cancer risk

LEAD A BALANCED LIFESTYLE Smart Eating & Drinking Habits

TOLL FREE 0800 22 66 22 www.cansa.org.za

| RECIPE |

A BOWL OF SOUP...

A steaming bowl of soup is a wholesome way to feed a family. Flavour your soups with herbs and spices instead of salty ingredients like stock cubes.

HEARTY BEAN SOUP Prep Time: Overnight plus 15 minutes Cook Time: 2 hours The dried beans, lentils and veggies make this a filling soup for winter. Beans and lentils are a healthy source of protein.

INGREDIENTS: • 1 cup (250ml) dried sugar beans • 1 tbsp (15ml) sunflower oil • 2 carrots, chopped • 1 onion, chopped • 1 clove of garlic, finely chopped | 30 | MELOMAG

• 8 cups (2 litres) Homemade stock or water with 3 tbsp dried mixed herbs • 1 tbsp (15ml) dried mixed herbs • 1 cup (250ml) uncooked brown lentils • 4 tomatoes, chopped • 1 tbsp (15ml) tomato paste • 2 cups (500ml) thinly sliced cabbage or spinach • ¼ cup (60ml) chopped fresh parsley • 2 tsp (10ml) sugar • ½ tsp (2,5ml) salt • lemon juice and black pepper to taste

METHOD: 1. Soak beans in 1 litre of water overnight.

2. Heat oil in a large pot and fry carrots, onion and garlic.

3. Stir in the stock, dried herbs, lentils and beans.

4. Bring to the boil and reduce the heat. Simmer with a lid for 1½–2 hours or until the beans are tender.

5. Add tomatoes, tomato paste and cabbage and simmer for another 15 minutes. Stir in the parsley, sugar and salt.

6. Season with lemon juice and pepper.

Source: http://cookingfromtheheart.co.za/cfth-recipes/ book-1/soups/

HONEY OAT BREAD This honey-oat bread has incredible flavours, perfect with a delicious bowl of soup.

It requires minimal mixing with ingredients usually stocked in the pantry.

HONEY OAT BREAD Prep Time: 15 min Ready In: 1 h 45 m

INGREDIENTS: • 1 cup (250ml) rolled oats, or quick-cooking (not instant) oats • 2 tbsp (30ml) oats for coating • 1⅓ cups (330ml) wholewheat flour • 1 cup (250ml) all-purpose flour • 2¼ tsp baking powder • ¼ tsp baking soda • 1¼ tsp salt • 1 cup (250ml) low-fat plain yoghurt • 1 large egg

• ¼ cup (62,5ml) canola oil • ¼ cup (62,5ml) honey • ¾ cup (188ml) low-fat milk METHOD: 1. Preheat oven to 180oC. 2. Generously coat a 15 x 23cm loaf pan with cooking spray. Sprinkle 1 tablespoon oats in the pan and coat the sides and bottom.

3. In a large bowl, stir together whole-wheat flour, all-purpose flour, baking powder, baking soda and salt.

4. Using a fork, beat the oats, yogurt, egg, oil and honey in a medium bowl until well blended. Stir in milk.

5. Gently stir the yogurt

mixture into the flour mixture until thoroughly incorporated but not overmixed. Scrape the batter into the pan, spreading evenly to the edges.

6. Sprinkle the remaining tablespoon oats over the top.

7. Bake the loaf until browned on top. 40 to 50 minutes. (It’s normal for the top to crack.)

8. Cool in the pan on a wire rack for 15 minutes.

9. Turn it out onto the rack and cool for a further 45 minutes.

Source: http://www.eatingwell.com/recipe/252305/honeyoat-quick-bread/

| 31 | MELOMAG

| HOUSE CALL |

MEET ONE OF OUR DEDICATED SPECIALISTS:

DR SIZWE MAKHOBA Dr Makhoba is a general surgeon and currently practices at Melomed Tokai and Melomed Mitchells Plain.

1. Where is your favourite place to eat, and why?

I’m a big fan of fine dining, where every mouthful is a culinary journey, so La Colombe is definitely high up on the list. Fish on the Rocks in Hout Bay is my all time favourite fish restaurant.

2. What is your most memorable travel experience?

Travelling is always fun! I had the opportunity to travel to Barcelona, Rome, Prague and Dubai last year and that was an incredible experience.

4. Which three songs would you listen to for the rest of your life, if you had to pick?

7. If you can speak any other language, what would it be and why?

This is a difficult one, my music taste is so broad.

Eminem – When I’m Gone, Linkin Park – Paper cut and any song by Euphonik. South African house music is just so amazing.

French! With a proper accent, followed by Spanish.

Both are very romantic and expressive languages.

8. If you could only keep 5 possessions, what would they be?

5. Whose biggest fan are you?

Lewis Hamilton or any F1 driver. The thrill of speed, seeing Monaco from the cockpit of a Formula 1 car!

Need I say more!

6. If you didn’t become a doctor what would your dream job have been?

3. Can you play any instruments, or what would To be a Formula 1 driver, professional cricket player or you play if you could? to eradicate crime in South Africa.

I wish I could play an

instrument! If I had to learn one now, it would be the guitar. | 32 | MELOMAG

My car, my house, MacBook, my watch and all my clothes.

9. Who would you want with you if you were stranded on a deserted island?

Bear Grylls.

10. Where do you most want to travel, but have never been?

So many places! Japan, China, India, Central Africa.

OUR GYNAECOLOGISTS AND OBSTETRICIANS ARE READY TO GUIDE AND SUPPORT EXPECTANT MOTHERS WITH THEIR EXCITING JOURNEY AHEAD.

BELLVILLE Dr N Mtimkulu Dr MS Jacobs Dr F Patel

021 950 8930 021 945 2970 021 917 1147

TOKAI Dr A Hendricks Dr B Woldu

021 712 2691 021 712 5144

GATESVILLE Dr N Allie Dr R Kader

021 637 4323 021 638 2647

MITCHELLS PLAIN Dr D Karangwa Dr G Khobane

021 391 4297 021 391 4132/3

www.melomed.co.za

RICHARDS BAY Dr J Moodley Dr SJ Kunene Dr RK Misra

035 772 1581 035 772 4848 035 902 8010

GATESVILLE & MITCHELLS PLAIN Dr A Davids Dr MA Jeeva Dr H Khamissa GATESVILLE: 021 637 1343/4 MITCHELLS PLAIN: 021 392 8141/0516

For more information contact us at info@melomed.co.za

PROVIDING AFFORDABLE QUALITY HEALTHCARE.

“Pathology that Adds Value”

Newborn Metabolic Screening is your newborn baby’s screening test for genetic and metabolic conditions.

24 conditions are screened for, including Cystic Fibrosis and Galactosaemia.

The test must be done 2-3 days after your baby’s first feed and the sample is acquired through a heel prick.

PathCare offers newborn metabolic screening. Please consult your doctor for more information.

021 596 3800

www.pathcare.co.za

clients@pathcare.co.za